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House winning Medicaid pay debate not so good for HCA, Tenet hospitals

Mark Wallheiser
Florida Speaker of the House Richard Corcoran (center) speaks to Republican leadership in the House and Senate Feb 23, 2018. (AP Photo/Mark Wallheiser)

Posted: 6:46 p.m. Wednesday, March 07, 2018

TALLAHASSEE
—

Helping end a budget impasse, lawmakers have agreed to keep a current Medicaid payment formula for hospitals and to increase funding for nursing homes by $40 million, the Senate’s top health-care budget writer confirmed Wednesday afternoon.

The agreement allowed the chambers to close out a roughly $87 billion spending plan for the fiscal year that starts July 1.

The House and Senate had taken different positions for weeks on hospital funding.

The House proposal was essentially a continuation of the Medicaid payment formula from the current year’s budget. The Senate, meanwhile, had proposed redistributing $318 million in Medicaid “automatic rate enhancements” currently paid to 28 hospitals with large Medicaid caseloads and use it to increase the rates paid for all hospitals.

The Senate proposal would have reduced Medicaid payments to Jackson Memorial Hospital in Miami by as much as $58 million and Orlando Health by nearly $9 million. House Appropriations Chairman Carlos Trujillo, R-Miami, said the House would not let safety-net facilities such as those face steep reductions.

HCA Healthcare, a for-profit chain that owns 43 facilities in the state, would have seen a nearly $40.5 million in Medicaid increase under the Senate plan. Tenet, which owns nine hospitals in Florida, would have seen a nearly $4 million increase in Medicaid payments under the Senate plan, and Community Health Systems, which owns 23 hospitals in Florida, would have seen as much as a $7.7 million bump in Medicaid payments.

Jan Gorrie, a lobbyist with the firm Ballard Partners who represents health-care clients such as Tampa General Hospital, said the decision maintains “access to care provided by our state’s safety net hospitals.”

Emmett Reed, executive director of the Florida Health Care Association, a major nursing-home group, issued a statement thanking legislative leaders for the additional money. The funding boost, which was a priority of Senate President Joe Negron, comes as the Medicaid payment system for nursing homes is poised to change this year.

Reed said the additional money will go a “long way to enhance quality and help care providers as they transition to the state’s new payment system this October.” Reed also thanked Negron, R-Stuart, for “recognizing the increasing costs of meeting the unique care needs of Florida’s nursing center residents.”

The impasse on health-care funding played a key role in causing legislative leaders to miss a Tuesday deadline for finishing the budget. Missing the deadline will force an extension of the annual legislative session, which was scheduled to end Friday. The budget needs to be finalized 72 hours before a vote can be taken because of a constitutionally required “cooling off” period.

House Speaker Richard Corcoran, R-Land O’ Lakes, announced the budget agreement Wednesday afternoon to House members. Senate Appropriations Chairman Rob Bradley, R-Fleming Island, also confirmed the deal in a tweet.

“We do believe that as of right now we have agreement on the budget,” Corcoran said about 1:15 p.m., drawing applause from House members.

It was not immediately clear Wednesday afternoon when the session extension would occur.

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